Redesigned Communications Lead to Better Health Outcomes

This client is one of the largest customer-owned health insurers in the nation with over 14 million members across multiple states. As a mutual insurance company, they are committed to empowering members with information and tools to make the best health care decisions at the best value.

The Challenge

This client wanted to create and deliver a health statement that was customizable, attractive and provided personally relevant information that guided members to better health outcomes and reduced costs. Prior to working with DataOceans, members received a black and white printed statement that was confusing, created unnecessary claims and service friction, and ultimately dragged down NPS scores.

This client was unable to implement an in-house solution in the past, as it required consolidating data from a wide range of different data sources, including those owned by third parties. While the client had access to a wealth of data and relevant content that could improve the member experience, it could not put that data into action. Further complicating the process was the fact that data files for ingestion into the solution were produced at different times, in disparate files formats, and contained different primary keys. Given the volume and complexity of data, the millions of documents that needed to be produced and the scarcity of internal IT resources, this client needed a CCM platform and a managed services partner that could get them live and support them over time.

The client also needed assistance with the design of the new health statement. For clarity, the new design needed to utilize color. It also needed to include variable content relevant to each member and allow for rapid and iterative changes based on member behavior and analytics. Members needed to receive one summary view in a quarterly or monthly health statement that could be delivered to them across multiple channels including mail and digital.

The Solution

The DataOceans team used our proprietary ETL tool to integrate with multiple systems, import the data in multiple formats, map it across multiple key fields and then transform it to a format that enabled production of a newly designed health statement. The team also designed the interactive, customizable document template containing all branding, layout and variable content insertion requirements.

Not only did the newly designed statement receive over 95% favorable ratings from members, DataOceans’ Targeted Content Manager enabled business users at the health insurer to manage presentation rules and content to be variably inserted. As a result, the time required to make changes to content was reduced by 85%. In addition, health and wellness information that was relevant to the member based on claims and demographic data could now be variable inserted, empowering the member to make better health decisions. Members also were provided educational content about the claims lifecycle, availability of generic drug equivalents and in-network options. This information reduced member claims calls and enabled members to reduce their health care costs.

Member usage of the newly designed statement and its content was so well received that over 90% of members were willing to recommend this health insurer and statement to friends who make health insurance purchasing decisions.

The DataOceans solution enabled the health insurer to access archived copies of all statements for compliance and customer service purposes. Employees were able to leverage analytics and content management capabilities to continue improving communications to member segments and to further reduce member service and claims costs as well as maximizing satisfaction.

The Future